NHS flagship sends away mothers in crisis

01:00Sunday 23 May 2004

A FLAGSHIP hospital is sending away mothers facing the trauma of premature birth an average of once a month and transporting patients up to 60 miles away to receive medical care, Scotland on Sunday can reveal.

The privately built Edinburgh Royal Infirmary opened just two years ago, but the neonatal ward has been forced to close to new admissions 11 times in the past year.

Critics claim that poor planning by health service managers has resulted in the 44-cot unit regularly reaching capacity and already-distressed mothers being taken by ambulance to Dundee or Glasgow.

The situation is even worse at Aberdeen Maternity Hospital, which has the only facility in the Grampian Health Board area for neo-natal care. Patients were transferred to other hospitals 25 times last year.

Some experts predict the situation will get worse and spread across Scotland as a result of a government review which will see a number of maternity units close as care is centralised.

Since 1999, the number of places in Scotland’s neonatal units has fallen by 19%, from 409 to 332. The Scottish Executive says the cut in numbers is justified by Scotland’s falling birthrate and advances in pre-natal care.

But over the same period, premature births have risen as a percentage of all babies born in Scotland, and more women are waiting until later in life to have their first child, a factor linked to complications during birth.

Despite costing 184m to build, the new ERI has been criticised for having too few places.

Just last weekend an expectant mother, who doctors believed might have a complicated birth, was transferred to Ninewells Hospital in Dundee, because the ERI was full.

The ERI’s problems may be exacerbated by the occasional lack of facilities in rural areas surrounding the city. Some of Edinburgh’s neonatal places are taken by patients from the Borders, which only has eight specialist places.

Last year, an expectant Edinburgh mother who lives just seven miles from the new hospital was sent to Dundee for treatment after she appeared to go into labour six weeks prematurely. Karen Grieve was sent to Ninewells by ambulance after hospital staff told her there were no neonatal beds available closer to home.

Grieve’s mother, Jackie Welsh, said the situation was "ridiculous". She said: "We are absolutely furious. This is a state-of-the-art hospital that is supposed to accommodate the citizens of Edinburgh but it can’t."

The problems in Edinburgh contrast sharply with Glasgow, where the Princess Royal’s neonatal unit closed its doors three times in the past year, and the Southern General just once. On all four occasions, patients were transferred to other hospitals in the city.

A senior source within Greater Glasgow Health Board expressed amazement at the number of times the ERI had been forced to transfer patients.

The insider said: "That strikes me as a very high number of transfers, especially for a hospital which is newly designed. I am astonished."

Dundee, despite taking Edinburgh and Aberdeen patients, has not transferred a single patient in the past year, according to a spokesman for Tayside Health Board.

Margaret Davidson, the chief executive of the Scotland Patients Association, said: "It is absolutely unacceptable that mothers-to-be are having to travel across Scotland in this way to receive the care they are entitled to. They have to rethink their whole policy on the provision of maternity services."

Shona Robison, the SNP’s health spokeswoman, added: "Edinburgh mothers deserve better, especially from what is supposed to be a brand new, expertly designed hospital."

In 1976, 3,809 babies were born prematurely, just 5.7% of all births. But last year, despite fewer babies being born, there were 3,936 premature births, 7.8% of all those delivered.

In 1976, just 19% of all births were to women over 30. Last year the number stood at 49%.

David Farquharson, clinical director for reproductive services at the Royal Infirmary of Edinburgh, acknowledged the transfer of the expectant mother last weekend.

"In the previous 24 hours there had been five admissions to the hospital’s neonatal unit. This is an unusually high number, and these admissions cannot be predicted," he said.

A Scottish Executive spokeswoman said: "The reorganisation of maternity hospitals and services is designed to respond to the falling birth rate in Scotland. Furthermore, developments in technology and enhanced antenatal screening and support mean that we are now seeing fewer sick babies needing to be admitted to neonatal units for special care."